Interventions are needed to reduce unhealthy alcohol use among low-income, marginally employed persons in the US, many of whom are minority populations. Among this population, Hispanics are the most rapidly growing minority group and Hispanic males are more likely than other minority groups to engage in heavy episodic drinking. Further, Hispanics are more likely than other racial/ethnic groups to die from liver disease and accidents;conditions associated with alcohol use. We are targeting midlife and older Hispanic men for interventions to reduce unhealthy alcohol use as they are higher risk for alcohol-related harm due to their advancing age and comorbidities that may be attributable to or worsened by alcohol. Integrating existing behavioral therapies for use in immigrant Hispanic populations and providing the therapies in their communities by community health promoters (promotoras) may improve the likelihood of treatment engagement and retention and reduce unhealthy alcohol use. The Instituto de Educacisn Popular del Sur de California (IDEPSCA) is a non-profit community-based educational organization that has a Workers Health Program to address the health needs of mostly immigrant day laborers and household workers in the greater Los Angeles area. The organization also operates 6 job centers where day laborers can come to find work. We propose to collaborate with IDEPSCA to integrate two evidence-based behavioral therapies: Motivational Enhancement Therapy and Strengths- Based Case Management and pilot test an intervention employing this integrated approach to reduce unhealthy drinking among middle-aged and older male, Hispanic day laborers who seek work at the job centers organized by IDEPSCA. The intervention will be delivered by promotoras who volunteer with IDEPSCA. The overall goal of the proposed work is to integrate the two therapies and begin to test an approach to maximize treatment engagement and retention and to reduce unhealthy drinking among a low income, marginally employed population of middle-aged and older Hispanic men. Our hypothesis is that the integrated intervention will improve outcomes of those who receive it compared to those who receive brief feedback. The long-term goal of this research is to improve identification and treatment of unhealthy alcohol use among socially disadvantaged Hispanic men by developing an effective, relevant, and relatively brief intervention that may be provided by community health promoters. An important aim of this project is to develop an intervention approach that is ultimately sustainable from IDEPSCA's standpoint.

Public Health Relevance

Interventions are needed to reduce unhealthy alcohol use among low-income, marginally employed persons in the US, many of whom are Hispanic and who have comorbidities and symptoms that may be worsened by alcohol use. Integrating evidence-based behavioral therapies, and training community health promoters (promotoras) to deliver them to immigrant Hispanic populations in their communities may increase the likelihood of success in engaging and retaining them in treatment and in reducing alcohol use. The overall goal of the proposed work is to partner with the Instituto de Educacisn Popular del Sur de California (IDEPSCA), a non-profit community-based educational organization that has a Workers Health Program, to address the health needs of mostly immigrant day laborers to integrate two evidence-based behavioral therapies: Motivational Enhancement Therapy and Strengths-Based Case Management, and begin to test a relevant and sustainable intervention to reduce unhealthy drinking among a low income, marginally employed population of middle-aged and older Hispanic men.